Letter to the Editor: Help Stop PEIA Takeaways, Public Hearing Thursday Night

Like many private employers,Public Employees Insurance Agency (PEIA), is again taking away benefits. It serves state, and many county, city, municipal, workers, teachers, school employees, state road, higher education, university physicians and staff, DHHR, state hospitals, some public transportation employees, and numerous others.

Not only is the (PEIA) increasing the family Out Of Pocket Maximum (OOPM) by an additional $400 to $750, to a high of $1600 to $4000, and has increased the copay nonpreferred desperately needed medication to 75%, but it is planning to raise monthly copays on generic and preferred brand name so called “specialty” medications to $85, and to $100 on nonpreferred brand specialty (an entirely new double whammy category). Worse they want to create an undefined mysterious “new specialty ‘benefit’ ”. They will no longer waive copayment for third tier diabetic medications. Note prescription OOPM is an overwhelming $1750 in addition to medical OOMP, and many complain about medications being moved to more expensive categories arbitrarily, with these medications being specifically discussed at public hearings. All these takeaways affect nonMedicare retirees too.

PEIA plans to hurt Plan A, the plan most are in, by trying to lure people to Plans B & D, costing a loss of maybe $1000 in benefits due to loss in $800 in matching funds for every $200 participants save. Plan C is even worse for loss of matching funds, as it also does not have a sliding scale (never mentioned in the initial public hearing presentation). All these alternate plans expose members to significantly higher deductibles and higher OOPMs, less matching funds, sometimes reduction of provider network, and always long term erosion of main better plans they will want when ill. Non-Medicare retirees will be offered a plan B that will hurt in the same ways, and PEIA fails to list premiums, OOPMs, and deductibles in handout. They want to “enhance” the medical home program, probably further complicating your physician flexibility and access, and costing members more.

Medicare retirees will be offered a supposedly “silver plan” that also reduces benefits and matching funds similarly and has higher deductibles and OOPMs . All this contributes to less funding for the unfunded liability and future lost benefits and higher premiums for the main plan. Some years ago PEIA forced all off the Jan. to Dec. year, to an awkward July to June plan year, where some would have been hurt in the transition. Now they want a 6 month plan year to transition back. But they propose a higher than ½ fee medical and prescription OOPMs, and do not address deductibles. Will retirees pay full medical/prescription deductibles for only 6 months, only to pay them again in Jan? Not addressed the yearly max. 20 therapy sessions. One may need them all in a few months after a stroke or accident, but could be denied ½ , if they are unlucky enough to have a stroke, in that partial year plan. Also there will be problems with those having up to $375 toward OOPM Jul to Dec, and then $725 Jan. to Jun, a total of $1100, $350 over a year’s OOPM, but without being capped at $750. From PEIA’s chart, they projected 7% retiree plan growth, but are experiencing 2.8 % cost reduction, (an almost 10% error) causing the retirees to pay a 36.8% match instead of 30% or 31% match, costing retirees millions, for which there was never a public hearing.

If concerned the PEIA Public Hearing is Thur. Nov. 15, 6:00 PM Marshall Medical School at University Physicians next to Cabell Huntington, Hospital) Harless Auditorium on 1st floor, 1600 Medical Center Drive, Huntington, WV. Come early to sign up to speak.